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Cleft Palate Repair Surgery

California rates for HCPCS 42200

This surgery repairs a cleft palate, a birth condition in which the roof of the mouth did not fully join together during development, leaving a gap between the mouth and nasal cavity. The surgeon closes the opening in the soft palate, hard palate, or both, restoring a continuous roof of the mouth to support normal speech, feeding, and swallowing. It's typically performed on infants or young children born with this condition.

Facilitymedian $10,471 · 10th–90th $2,188$17,7830%10%10th90th$10,471Professionalmedian $1,175 · 10th–90th $832$3,6310%20%10th90th$1,175$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$10,000.00
Typical High
$20,892.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,258.93
Typical High
$4,466.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$11,481.54
Typical High
$17,782.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,122.02
Typical High
$2,238.72
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$7,413.10
Typical High
$15,135.61
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,348.96
Typical High
$2,630.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$3,467.37
Typical High
$7,413.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,148.15
Typical High
$2,238.72
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$977.24
Typical High
$1,318.26
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$3,090.30
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$16,982.44
Typical High
$42,657.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$9,772.37
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,318.26
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,174.90
Typical High
$1,949.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,148.15
Typical High
$2,344.23
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$3,090.30
Median
$3,090.30
Typical High
$3,090.30
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,023.29
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$11,220.18
Typical High
$25,118.86
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,000.00
Typical High
$2,041.74